Terms of Reference (TOR) for Mid-term Evaluation.

Addis Ababa
Amref Health Africa

Amref Health Africa is an international non-profit organization that was founded in 1957 in East Africa, seeking to provoke healthcare improvement of significant importance in Africa. Its Headquarters are based in Nairobi, Kenya, and it also has country offices in Ethiopia, Kenya, Uganda, Tanzania, Senegal, South Africa, and Southern Sudan.


Although Amref Health Africa has been formally registered in Ethiopia in 1998, a full-fledged country program with a country office started in 2002. Since then, the country program has grown from one project in Addis Ababa to over 20 projects in seven regions (Addis Ababa, Afar, Oromia and Southern Nation, Nationalities and People Region, Amhara, Benshangul Gumez and Gambela). Amref Health Africa in Ethiopia is working in health development with the motto of lasting health change in Ethiopia.


Amref Health Africa in Ethiopia strongly believes that there is an acute gap between vulnerable communities and the formal Ethiopian health system. To contribute towards closing the gap, Amref Health Africa has chosen to act in a holistic and integrated way, focusing thematic areas: (1) WASH, (2) RMNCH (3) CD/NCD (4) Nutrition and including cross cutting HRH, Health system strengthening. Currently, Amref Health Africa in Ethiopia is also working a project focusing on sanitation marketing, and Agriculture, rural development and Transformation (S.M.A.R.T) in Gambella, Region.

1.      Project description

1.1      Background


In partnership with VIS, Amref Health Africa in Ethiopia, obtaining fund from Italian Agency for Cooperation to Development (Aics) is designed term of reference for mid-term evaluation  for ” S.M.A.R.T Project in Gambella Region, Gambella Zuria Woreda district.



The project will contribute to the wellbeing of poor communities reside in disadvantaged group corners of the project intervention regions. Small-scale enterprises engaged in WASH businesses do not have access to adequate finance & lack entrepreneurial skills to become more actively involved in WASH services. Microfinance opportunities are minimal, as MFIs lack a proper understanding of the WASH sector and its business potential. These WASH problems are clearly interlinked with livelihood/ agriculture or livestock farming. This project aims to tackle these problems by working towards a sector where Agriculture, and sanitation markets provide sustainable livelihood for the most vulnerable people in this region.


1.2      Implementation Modality

The main focus of the project is being innovative to ensure sustainable use of sanitation marketing, agriculture or livestock farming and rural development transformation. The stakeholders such as households, local government, micro finances supposed to play key roles in bringing the system into place. The project brings these parties together to collaborate and ensure that safe water & good sanitation becomes possible for region.

1.3      Project Summary


A change both at Community and institutional level through the following components integrated into the development intervention.

1. Promoting new skills in agricultural/livestock farming through lifelong learning with a methodology suitable for young people and adults outside the formal school cycle – both to increase and diversify livelihood (thus lowering the indirect effect of the malnutrition rate) and to promoting Income generating activities.

2. Introduction of innovative methodologies for socio-economic development through sanitation marketing, which improves quality of and access to sanitation.

3. Promotion of an integrated approach to water supply/sanitation with a Sanitation Master Plan developed in collaboration with local authorities.

4. Identification of good practices to facilitate replicability of the intervention. This change will be achieved by integrating the ‘hardware’ component of infrastructures with the ‘software’ of awareness-raising and training activities, in synergy with the agricultural training pathways for multi-sectoral development. The project will promote access to clean water and sanitation as a key requirement for improving medium and long-term living conditions linked to education, health, nutrition, dignity, opportunities, security, and growth.

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